Nursing Elites

1. A 50-year-old woman has had a relapse of her multiple sclerosis (MS) after several years of being symptom-free. Which of the following factors is most likely to have contributed to her relapse?

• A. Emotional stress
• B. Dietary indiscretion
• C. Physical overexertion
• D. Adequate rest and relaxation

Correct answer: C

Rationale: The correct answer is C: Physical overexertion. In individuals with multiple sclerosis (MS), physical overexertion can exacerbate symptoms and contribute to a relapse. It is important for individuals with MS to balance physical activity to avoid triggering symptom reoccurrence. Choices A, B, and D are less likely to have directly contributed to the relapse. Emotional stress and dietary indiscretion may play a role in exacerbating symptoms in some individuals, but physical overexertion is more commonly associated with MS relapses. Adequate rest and relaxation are important for overall well-being but are not typically linked to MS relapses.

2. A staff member asks what leukocytosis means. How should the nurse respond? Leukocytosis can be defined as:

• A. A normal leukocyte count
• B. A high leukocyte count
• C. A low leukocyte count
• D. Another term for leukopenia

Correct answer: B

Rationale: Leukocytosis refers to an abnormally high leukocyte count. This condition is characterized by an elevated number of white blood cells in the bloodstream. Choice A is incorrect because leukocytosis does not refer to a normal leukocyte count. Choice C is incorrect as leukocytosis is not related to a low leukocyte count. Choice D is incorrect as leukopenia is the opposite of leukocytosis, indicating a low white blood cell count.

3. A 52-year-old has made an appointment with his primary care provider and has reluctantly admitted that his primary health concern is erectile dysfunction (ED). He describes the problem as increasing in severity and consequent distress. Which of the nurse's assessment questions is most likely to address a common cause of ED?

• A. “How would you describe your overall health status?”
• B. “Are you taking any medications for high blood pressure?”
• C. “How has this issue been impacting your relationship?”
• D. “Have you experienced any recent injuries?”

Correct answer: B

Rationale: In the context of erectile dysfunction (ED), medication use is a crucial factor to consider. Many medications, including those used for high blood pressure, can contribute to ED as a side effect. Asking about medication use, particularly for conditions like high blood pressure, can help identify a common cause of ED. Choices A, C, and D do not directly address potential causes related to medication use, making them less likely to reveal a common underlying issue for ED in this case.

4. In discussing sex hormone production with the patient, the nurse should describe that testosterone is normally secreted in response to

• A. sexual arousal.
• B. stimulation by luteinizing hormone.
• C. ACTH release by the adrenal cortex.
• D. decreased cortisol levels.

Correct answer: B

Rationale: Testosterone production is regulated by the hypothalamic-pituitary-gonadal axis. Luteinizing hormone (LH) stimulates the Leydig cells in the testes to produce testosterone. Therefore, the correct answer is B. Choice A, 'sexual arousal,' is incorrect because testosterone secretion is not directly linked to arousal but rather to hormonal stimulation. Choice C, 'ACTH release by the adrenal cortex,' is incorrect as testosterone production is not primarily regulated by adrenocorticotropic hormone (ACTH). Choice D, 'decreased cortisol levels,' is also incorrect as cortisol and testosterone are regulated by separate endocrine pathways.

5. The nurse knows which phenomenon listed below is an accurate statement about axonal transport?

• A. Anterograde and retrograde axonal transport allow for the communication of nerve impulses between a neuron and the central nervous system (CNS).
• B. Materials can be transported to the nerve terminal by either fast or slow components.
• C. The unidirectional nature of the axonal transport system protects the CNS against potential pathogens.
• D. Axonal transport facilitates the movement of electrical impulses but precludes the transport of molecular materials.

Correct answer: B

Rationale: The correct answer is B. Axonal transport involves the movement of materials to the nerve terminal by either fast or slow components, which is essential for cell survival. Choice A is incorrect because while anterograde and retrograde axonal transport are involved in the movement of materials, they do not specifically relate to the communication of nerve impulses between a neuron and the CNS. Choice C is incorrect because the unidirectional nature of axonal transport does not primarily function to protect the CNS against pathogens. Choice D is incorrect as axonal transport is responsible for the movement of various materials, not just electrical impulses.

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